title: New dried human amniotic membrane is useful as a substitute for dural repair after skull base surgery.
abstract: Objectives Cerebrospinal fluid (CSF) leakage is an undesirable complication of skull base surgery. We used dried human amniotic membrane (AM) as a patch graft for dural repair to determine its efficacy in preventing CSF leakage. Design Frontoparietal craniotomy and removal of dura were performed in 20 Wistar rats. A dried AM was placed to cover the dural defect without suturing in 16 animals. In four animals, an expanded polytetrafluoroethylene was implanted. At 2 weeks and 1, 3, and 6 months, histological examination was performed. Dried AM was also used as a substitute in 10 patients who underwent skull base surgery, after approval by the Ethics Committee of the University of Toyama. Results At 2 weeks after implantation, thick connective tissue completely enclosed the dried AM. At 1 month after implantation, the connective tissue became thin and the implanted AM shortened. At 3 and 6 months after implantation, histological examination revealed disappearance of the dried AM and formation of membranous tissue. In the clinical study, neither CSF leakage nor clinical adverse reactions directly related to the dried AM were observed. Conclusion Dried human AM appears to be an ideal substitute for dura, since it is replaced by natural tissue.
authors.affiliation: Departments of Neurosurgery, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences, Toyama, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tomita
authors.forename: Nakamasa
authors.initials: N
authors.lastname: Hayashi
authors.forename: Motonori
authors.initials: M
authors.lastname: Okabe
authors.forename: Toshiko
authors.initials: T
authors.lastname: Yoshida
authors.forename: Hideo
authors.initials: H
authors.lastname: Hamada
authors.forename: Shunro
authors.initials: S
authors.lastname: Endo
authors.forename: Toshio
authors.initials: T
authors.lastname: Nikaido
keywords: amniotic membrane; cerebrospinal fluid (CSF) leakage; dural repair; dural substitute; skull base surgery